Sharon Levy, MD, MPH*:<\/strong> The US went through a distinct series of \u201cwaves\u201d of the opioid epidemic.The overdose crisis got much worse when fentanyl started contaminating the drug supply. Illicit manufacturers could press counterfeit pills that look identical to pharmaceutical products. A high proportion of them were contaminated with fentanyl.\u00a0<\/p>\n\n\n\n Social media made it feasible for people to sell these pills to people who probably would otherwise never buy them from a typical \u201cdrug dealer\u201d. Overdoses, including among adolescents, shot through the roof, and 2\/3 of young people who overdosed were not known to have an opioid use disorder \u2013 in other words, they were \u201csporadic\u201d users who took a contaminated pill and overdosed.<\/p>\n\n\n\n Over the past few years overdose rates have started to decline in most demographics, including among adolescents. The declines are thought to be linked to naloxone distribution and education. Unfortunately overdose deaths are still extremely high, nearly 70,000 in 2025.<\/p>\n\n\n\n What is the situation like in Europe? <\/strong><\/p>\n\n\n\n In general, Europe has reported far fewer opioid overdoses than North America, though there are some things to watch out for, including increasing rates of chronic pain<\/a> diagnoses and opioid prescribing in some areas. Fentanyl does not appear to have entered the European markets to any large extent, but it is important to continue to surveil.<\/p>\n\n\n\n A study you co-led found that even using cannabis once or twice a month is associated with greater emotional difficulties and poorer school functioning among adolescents. Why can such a seemingly small amount of use have meaningful consequences?\u00a0<\/strong><\/p>\n\n\n\n The association we found was very striking and in alignment with other work that has found that cannabis use during adolescence is associated with changes in brain architecture and declining IQ in adulthood. At this point, the science tells a clear story that cannabis use during adolescence interferes with brain development during critical windows. <\/p>\n\n\n\n It is true that cannabis products in the US have become much more potent over the past few decades, and that has made them more addictive and resulted in greater adverse effects or harms.<\/p>\n\n\n\n Over the years, you have treated thousands of adolescents struggling with substance use disorders. What has changed the most in the profile of your young patients over the past 15\u201320 years? Have the substances themselves changed, or have the reasons why young people turn to them changed more significantly?<\/strong> Nonetheless, the rates of substance use problems and disorders among those who use have been increasing, and this is largely attributed to the trend towards increasingly potent substances available on the market. Highly potent cannabis products are now easily available as are highly potent nicotine e-cigarettes. <\/p>\n\n\n\n Fentanyl contamination is common and young people who access \u201cpills\u201d through social media<\/a> can be inadvertently exposed, leading to overdose. As a result, higher proportions of teens who try a substance end up having a serious consequence or developing a substance use disorder.<\/p>\n\n\n\n The environment is also changing. Rates of depression and anxiety have skyrocketed among US teens. Promotion of drugs (especially cannabis at this moment in time) has led to many young people using them to treat a physical or mental health symptom. Mental and physical health problems have always gone hand in hand with substance use disorders, in the current environment co-occurring disorders are becoming even more common.<\/p>\n\n\n\n You treat young people affected by alcohol, nicotine, cannabis, opioids, and prescription medication misuse. Are there common characteristics, experiences, or patterns that connect most adolescents who come to your clinic, regardless of the substance involved?<\/strong><\/p>\n\n\n\n![\"Close-up](\"https:\/\/holistic.news\/en\/wp-content\/uploads\/2026\/07\/teen_addiction_1-1024x576.jpg\")
Why even occasional cannabis use can matter<\/h2>\n\n\n\n
Teen addiction often begins as a search for relief<\/h2>\n\n\n\n
In the US, national surveys over the past decade or so have found dropping rates of adolescent substance use for most substances, including alcohol, cigarettes, illicit drugs, and prescription medications. Rates of cannabis use have been mostly flat, and rates of e-cigarette use have been unstable.<\/p>\n\n\n\n![\"A](\"https:\/\/holistic.news\/en\/wp-content\/uploads\/2026\/07\/teen_addiction_2-1024x576.jpg\")